An Initial Health Assessment (IHA) is a statutory health assessment for every child or young person entering the care system in the UK. It provides a comprehensive review of physical, mental, and emotional health and wellbeing. During the assessment, the clinician identifies the services and support needed to meet the child’s individual needs, such as vaccinations, referrals to specialist care, further investigations, and community-based resources.
This process is vital to ensure that children and young people access timely, appropriate care. Until now, there have been no national standards for IHAs. These newly developed standards fill that gap, setting clear expectations and aiming to improve health outcomes for children and young people in care.
These standards provide a landmark framework designed to improve the experience, outcomes, and overall wellbeing of children and young people in care settings, including those:
- placed out of area;
- seeking asylum or who are refugees;
- living in secure settings; or
- receiving prolonged respite care due to disability
Badged by CoramBAAF and developed with input from a wide range of professionals including paediatricians, General Practitioners, nurses, social workers, and researchers, the standards are also informed by a literature review investigating children’s views on IHAs.
These standards will empower clinicians across all four UK nations to identify excellence and target areas for improvement. Each standard is accompanied by practical guidance, supporting progress even where full compliance may take time.
RCPCH encourages all health and social care professionals involved in the delivery of IHAs, such as paediatricians, nurses and social workers, to review these standards carefully and embed them in their current practice where possible.
In addition, the College strongly urges those responsible for commissioning or providing health and care services to ensure the model of service provision incorporates these standards. The standards also offer an opportunity for academic evaluation in the future to further improve the systems surrounding vulnerable children in our society.
Read the full standards and literature review
Professor Andrew Rowland, Officer for Child Protection at the Royal College of Paediatrics and Child Health, said:
Children in care deserve the same high-quality healthcare as any other child, and these standards are a vital step toward achieving that. For too long, the absence of clear national guidance has led to inconsistency in how Initial Health Assessments are delivered, which can have a lasting impact on health outcomes.
By setting out practical, evidence-based expectations, we are giving clinicians the tools they need to provide care that is safe, inclusive, and responsive to individual needs. Importantly, these standards embed the voices of children and young people at their core, thus ensuring their experiences help shape the services designed for them. This is about raising the bar for care and ensuring that every child, regardless of circumstance, has the best possible start to a healthier future.
Dr Lynn Snow, RCPCH Looked After Children Lead & Project Clinical Lead, said:
Developing these standards has been an invaluable opportunity to make a real difference for children and young people undergoing an Initial Health Assessment (IHA). Wherever they live and whatever their circumstances, they should expect a comprehensive, consistent assessment delivered by staff and services focused on achieving the best outcomes with them.
This has been a stimulating project, and my hope is that these standards will serve as a practical tool which helps individual professionals improve their practice and supporting service development with providers and commissioners. Ultimately, a well-delivered holistic health assessment can have a lasting positive impact on a child or young person’s long-term health and wellbeing.